Strontium Carbonate Products

Strontium citrate is more readily absorbed than strontium carbonate, just as calcium citrate is more readily absorbed than calcium carbonate. If you eat food when you take calcium carbonate, you can get around the absorption problem, but, for best absorption, strontium should be taken on an empty stomach. You must not take food, supplements, or antacids containing calcium or magnesium within two hours of taking strontium because calcium and magnesium compete for absorption with strontium. For best absorption, strontium should be taken on an empty stomach.

Some people cannot take citrate products due to digestive problems. They may be interested in one of the following two strontium carbonate products. 

1.  

 BioStrong Strontium Piperine contains 680 mg strontium (as strontium carbonate) and BioPiperine (black pepper extract) in two tablets. Piperine improves absorption.

http://www.healthconcernsblog.com/wp-content/uploads/2014/02/BioStrong.pdf

https://www.pureformulas.com/biostrong-90-tablets-by-health-concerns.html

2.      OsteoValin by Basic Research contains 400 IU vitamin D, 80 mcg vitamin K, and 1012 mg Osteoval Carbonate Forte Proprietary Blend of strontium carbonate, Quercetin, and Hesperidin in one capsule. NEVER EXCEED 1 CAPSULE PER DAY.

Quercetin and Hesperidin are flavonoids. Flavonoids are generally considered beneficial anti-oxidants, but there is some controversy about Quercetin. An FDA study on rats found Quercetin to be mutagenic. Other studies indicate it works to prevent cancer. Quercetin is also an anti-histamine and an anti-inflammatory. I found a website with references and a balanced discussion on the pros and cons of Quercetin at http://www.diet-and-health.net/Supplements/Quercetin.html.

Hesperidin is a flavonoid found in citrus fruits. It is part of vitamin P. As a powerful anti-oxidant, it has many benefits from retarding the aging process to helping the body detoxify carcinogens.

I am not aware of any specific benefit to bones for either Quercetin or Hesperidin.

http://www.i-supplements.com/osteovalin.html

http://www.osteovalin.org/

 https://www.ghpnutrition.com/basic-research-osteovalin-eu4180007.html

IOF One-Minute Osteoporosis Risk Test

Are you among the one in three women, and the one in five men over the age of 50 who will be affected by osteoporosis in their lifetimes?

Osteoporosis weakens bones and leads to fractures. It causes severe disability. But osteoporosis can be detected early. It can be treated.

If you knew something that could harm you was coming, wouldn't you avoid it?

The test consists of 19 easy questions to help you understand the status of your bone health.

http://www.iofbonehealth.org/iof-one-minute-osteoporosis-risk-test

Amino Acid Intake and BMD

Jennings et al reported analyses of female identical twins with different amino acid intakes.

Twins with higher intakes of alanine and glycine had higher BMD at the spine than their co-twins, with within-pair differences in spine BMD of 0.012 g/cm² and 0.014 g/cm², respectively.

In cross-sectional multivariable analyses of 3,160 females aged 18-79 years, a higher intake of total protein was associated with higher BMD at the spine (quartile Q4 to quartile Q1: 0.017 g/ cm²) and forearm (Q4 to Q1: 0.010 g/cm².

Intake of alanine, arginine, glutamic acid, leucine, lysine, and proline was associated with higher BMD at the spine and forearm, with the strongest association observed for leucine (Q4 to Q1: 0.024 g/cm²).

When intakes were stratified by source, vegetable or animal, prevalence of osteoporosis or osteopenia was 13% to 19% lower comparing extreme quartiles of vegetable intake for five amino acids (not glutamic acid or proline).

Jennings A, MacGregor A, Spector T, Cassidy A. Amino acid intakes are associated with bone mineral density and prevalence of low bone mass in women: Evidence from discordant monozygotic twins. J Bone Miner Res 2015; doi:10.1002/jbmr.2703.

Impact of Treatments for Postmenopausal Osteoporosis on Bone Quality

I came across an excellent review on the impact of treatments for postmenopausal osteoporosis on bone quality. The review covers teriparatide (Forteo), bisphosphonates, strontium ranelate, and denosumab (Prolia). Since strontium is the active ingredient in strontium ranelate, I think it’s safe to assume the same positive changes in bone quality occur with strontium citrate.

“The objective of this systematic review was to examine the influence of treatments for postmenopausal osteoporosis (parathyroid hormone [PTH], bisphosphonates, strontium ranelate, and denosumab) on bone quality and discuss the clinical implications.”

“Most bone-quality data for PTH is from teriparatide. Teriparatide results in a rapid increase in bone-formation markers, followed by increases in bone-resorption markers, opening an “anabolic window,” a period of time when PTH is maximally anabolic. Teriparatide reverses the structural damage seen in osteoporosis and restores the structure of trabecular bone. It has a positive effect on cortical bone, and any early increases in cortical porosity appear to be offset by increases in cortical thickness and diameter.”

“Bisphosphonates are antiresorptive agents which reduce bone turnover, improve trabecular microarchitecture, and mineralization. Concerns have been raised that the prolonged antiresorptive action of bisphosphonates may lead to failure to repair microdamage, resulting in microcracks and atypical fragility.”

“Strontium ranelate is thought to have a mixed mode of action, increasing bone formation and decreasing bone resorption. Strontium ranelate improves cortical thickness, trabecular number, and connectivity, with no change in cortical porosity.”

“Denosumab exerts rapid, marked, and sustained effects on bone resorption, resulting in falls in the markers of bone turnover.”

“Evidence from bone-quality studies suggests that treatment-naive women, aged 60–65 years, with very low BMD T scores may benefit from PTH as primary therapy to improve bone substrate and build bone.”

“Post-PTH treatment with bisphosphonates will maintain improvements in bone quality and reduce the risk of fracture.”

http://link.springer.com/article/10.1007/s00223-010-9420-x

Fracture Warnings for Invokana and Invokamet Diabetes Drugs

“The US Food and Drug Administration (FDA) has strengthened its warning for canagliflozin (Invokana, Invokamet, Johnson & Johnson/Janssen) related to the increased risk for bone fractures.”

“The …product label for canagliflozin had already mentioned the risk for bone fractures. Now, based on new confirmatory information from several clinical trials, the FDA has added further warning and precaution information. In the trials, the fractures affected the upper extremities, occurred as early as 12 weeks after starting the drug, and typically arose from minor trauma such as falling from a standing height.”

“The FDA has also added new information to the label about decreased bone mineral density at the hip and lower spine.”

“The FDA is also evaluating the possible risk for bone fractures for other drugs in the sodium glucose cotransporter 2 (SGLT2) inhibitor class, including dapagliflozin (Farxiga, Xigduo XR, AstraZeneca) and empagliflozin (Jardiance, Glyxambi, Synjardy, Lilly/Boehringer Ingelheim), to determine whether additional label changes or studies are needed. The label for Farxiga mentions a small number of cases of fractures in patients with renal impairment; the Jardiance prescribing information does not mention bone effects.”

“…SGLT2 inhibitors increase concentrations of phosphate in serum, probably via increased tubular reabsorption, which has the potential to adversely affect bone.”

“Furthermore…SGLT2 inhibitors increase concentrations of parathyroid hormone (PTH). Sustained increases in PTH concentration enhance bone resorption and increase the risk for bone fractures.”

"Although canagliflozin causes a small increase in mean PTH concentration (7.9%), the standard deviation is large. Thus, a substantial number of patients treated with canagliflozin might have a 50% or greater increase in PTH concentrations — a change that could be clinically significant…"

Simeon I. Taylor, MD, professor of medicine at University of Maryland School of Medicine in Baltimore, said, "Although not proven, I believe that increased risk of bone fracture is likely a class effect. Nevertheless, individual drugs differ with respect to selectivity for SGLT2 vs. SGLT1, and also with respect to where on the dose-response curve the approved dose falls. So, it is certainly possible that the magnitude of the risk could vary among individual SGLT2 inhibitors."

http://www.medscape.com/viewarticle/850835